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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does The Following MRI Report Indicate?

6 weeks ago I slipped off a step, inverting my ankle. I heard a pop, immediately felt pain & had swelling. For 48 hours I iced and stayyed off of it. 7 days later I had xrays that show no fractures. I was out in an Aircast. Six weeks out, I can ambulate but have pain, swelling and limited motion, even with resting, icing, strengthening and taking meds. My orthopedic sports medicine doctor ordered an MRI. Results came back, which we reviewed together, and he diagnosed me with a grade 3 sprain and referred me to an orthopedic surgeon. I met with the surgeon today. He was indifferent and a bit dismissive. He did some tests on the foot, diagnosed a grade 2 sprain and referred me to 8 weeks of therapy. Here are my MRI Results. I m confused about the 2 diff diagnosis and am wondering if I need another opinion. 1) full-thickness tear of anterior talofibular ligament 2) moderate amount of fluid surrounding the tibial posterior, flexor digitorum longus, and flexor hallicus longus at the level of the ankle joint w No significant fluid beyond the intersection of the posterior digitorum longus and flexor hallicus longus. 3) Trace fluid around the supramalleolar ketone is longus breaks tendons. 4) Fluid extending through the inferior notch of the syndesmosis although the AITFL & PITFL are intact 5) Sunchondral bone marrow edema in heel bone with minimal cartilage fraying 6) mild tenosynovitis of flexor tendons Should I get a second opinion from another surgeon given the suffering grade 2/3 diagnosis?
Thu, 16 Apr 2020
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Pediatrician 's  Response
Hi,

You need not get confused of two different diagnosis- grade 2& 3 sprains have somewhat overlapping features and are difficult to differentiate clinically (depending on complete / partial tear of ligaments). Ankle ligament tears seldom needs surgical repair. Most of them can be managed with strict immobilisation in the acute stage and analgesics.

Now it is already 6 weeks- so now we can apply an ankle binder, do physiotherapy and muscle strengthening exercise. Your orthopedist has given you the apt advise, be confident and keep follow up.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Muhammed Aslam T. K., Pediatrician
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What Does The Following MRI Report Indicate?

Hi, You need not get confused of two different diagnosis- grade 2& 3 sprains have somewhat overlapping features and are difficult to differentiate clinically (depending on complete / partial tear of ligaments). Ankle ligament tears seldom needs surgical repair. Most of them can be managed with strict immobilisation in the acute stage and analgesics. Now it is already 6 weeks- so now we can apply an ankle binder, do physiotherapy and muscle strengthening exercise. Your orthopedist has given you the apt advise, be confident and keep follow up. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Muhammed Aslam T. K., Pediatrician